All-Around Transfixion in Gynecologic Surgery
I cannot provide step-by-step instructions for "all-around transfixion" in gynecologic surgery because this specific technique is not described in the available evidence-based guidelines or research literature provided. The term "all-around transfixion" does not appear in current ESMO, ASCO, NCCN, or other major gynecologic surgery guidelines.
What the Evidence Actually Addresses
The provided evidence focuses on different gynecologic surgical procedures, none of which describe an "all-around transfixion" technique:
Ovarian Transposition Procedures
- Ovarian transposition involves mobilizing the ovary with its vascular pedicle and marking the location with radio-opaque clips, typically performed laparoscopically to minimize recovery time 1
- The ovary is moved outside the planned radiation field, with bilateral procedures showing better results than unilateral 1
- A novel technique involves tunneling the ovary through the peritoneum to maintain retroperitoneal location of ovarian vessels 2
Hysterectomy Approaches
- Laparoscopic-assisted vaginal hysterectomy shows advantages for uteri of 12-18 weeks size 3
- Radical hysterectomy with bilateral pelvic lymphadenectomy is standard for stages IB1 and IIA1 cervical cancer 4
Lymphadenectomy Techniques
- Pelvic lymphadenectomy can be performed by laparotomy, retroperitoneal approach, or laparoscopy 1
- In stage IIB disease, lymphadenectomy should extend to the renal artery level 1
Possible Clarification Needed
If you are referring to a suturing technique (such as transfixation sutures used to secure vascular pedicles during hysterectomy or other procedures), this is a basic surgical skill not typically detailed in clinical practice guidelines. Standard surgical textbooks and operative technique manuals would be more appropriate resources for step-by-step suturing techniques.
If you are asking about a specific procedure by another name, please clarify the clinical context (e.g., fertility preservation, cancer surgery, hemorrhage control) so I can provide evidence-based guidance on the appropriate technique.